Unit 2 Assignment MCO and ACO GSutton-Pasco

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May 24, 2024

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Unit 2 Assignment: Ethical and Legal Decision-Making Dilemma Guyla J. Sutton-Pasco Purdue Global MN506 Health Policy, Ethical, and Legal Perspectives of The Health Care System Michael Palacio, NP April, 24, 2024 1
Unit 2 Assignment: Ethical and Legal Decision-Making Dilemma In advanced nursing there are many ethical and legal decision-making dilemmas that a nurse can face especially that of a nursing administrator weighting the health care need of patients versus allocation of resources. It is important to define the dilemma to have a better understanding while considering the main principles of ethics: autonomy, beneficence, justice, and non-maleficence. It is also important to understand the federal and state laws regarding this dilemma and the adherence to those laws pertaining to liability. Then the nurse should look at the relevant codes of conduct and how those are reflected in the dilemma while defining the ethical principle it may affect. Once this is done, it is important to construct a decision and make recommendations that will resolve the dilemma to ensure moral distress is resolved ( Westrick, 2013) . Ethical and Legal Decision-Making Dilemma The ethical dilemma in this situation is regarding a nurse administrator determining the health care need for patients versus resources that can be allocated for those needs to be met. For this example, we will utilize the need of dialysis machines in a rural hospital that typically does not see patients for this, however if a dialysis patient came in for emergency care and needed dialysis the machine it would be needed. Although it can be a life saving resource for patients with dialysis, the odds in rural areas are that most dialysis patients would not need this machine unless it was a true emergency as typically, they have programs already set up to receive dialysis on a regular basis. Legally speaking per Centers for Medicare & Medicaid (CMS) hospitals in the United States hospitals are not required to have a dialysis machine but are strongly encouraged. This presents less legal implications for an advanced practice nurse or provider who was working in an emergency room but does not necessarily ensure patient’s best care is being 2
met. It also reduces the legal implications for the nurse administrator. With these ethical and legal dilemmas being presented, one could see how a nursing administrator must deal with if it is a good healthcare allocation for a rural hospital to obtain a dialysis machine (CMS, 2023). Relevant Codes of Conduct In emergency rooms and advanced practice nurse or physician, will deliver emergency care, intensive care and critical care services for patients arriving at times unknown to the unit. In reviewing codes of conduct for nursing there are several codes of conduct that this dilemma can apply to. One of the main ethical guidelines in nursing pertaining the administrator nurse is determining if this is a cost-effective allocation of resources is to consider improvement of community health. Essentially, they should ask themselves would this dialysis machine help improve community health if there was even one dialysis patient that it was used for? Another code of conduct to consider is to have attention the medical health at the local level with goals to achieve optimal health for those individuals they serve. Also, in the nursing profession especially as a nursing administrator is importing to within their own limits attempt to provide a safe and health promoting environment for patients. With this consideration, what would be the best option for a rural dialysis patient if they couldn’t make it to a more populated hospital for treatment? Along side this the answer comes in another ethical principle or code of conduct to have nursing educators and administrators employ the maximum efforts to update their scientific knowledge and promote ethical knowledge and conduct within this a nurse administrator should make sure those resources were available and allocated to them. By applying these codes of conduct a nursing administrator in this situation could employ valuable insight on whether it was cost effective to have a dialysis machine ( Zahedi, et al, 2013). 3
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